Issue 20: Links between the maltreatment of girls & later victimization or use of violence

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VIOLENCE AGAINST WOMEN AND GIRLS: A PUBLIC HEALTH ISSUE

1 in 3 Canadian women will experience at least one incident of physical or sexual violence in their lifetime.1

Violence against women and girls is a global public health issue and a significant violation of human rights. Approximately one third of Canadian women will first experience abuse in childhood.2 Many of these women will continue to experience violence across the life course; some will use violence in subsequent peer, intimate, or family relationships.3 Multiple experiences of violence can result in negative health outcomes that accumulate over time.4 Exploring how trajectories of violence may unfold for women and girls is critical to improving prevention efforts. This newsletter provides an overview of the literature linking early experiences of violence to later use or revictimization.

Using the term “revictimization”

The link between early and later experiences of victimization is commonly referred to as revictimization. We use this term for readability; however, we recognize not all experiencing violence identify with or use the term “victim”.

FUNDAMENTALS TO REMEMBER

1

IDENTITY IS COMPLEX

2

VIOLENCE AS A CONTINUUM

3

CONTEXT IS KEY

Women and girls affected by
violence may identify anywhere
along the spectrum of gender
identity (e.g. trans*, cisgender,
genderqueer).

Women and girls are diverse and
may simultaneously identify with
multiple groups (e.g. Indigenous,
older, disAbled).

Violence occurs in many forms.
This includes but is not limited
to: physical violence, sexual
violence (e.g. assault, harassment),
psychological violence, harmful
sociocultural practices (e.g. female
genital mutilation), and structural
violence (e.g. sexism, ageism,
racism).

Violence and violence causing
serious injury or death is
disproportionately perpetrated
against women by men. Women
who use violence often do so in the
context of their own victimization.
The broader social context (e.g.
historical and current oppressions)
impacts these lived experiences.

REVICTIMIZATION ACROSS THE LIFE COURSE

Revictimization can occur within the same life stage or across life stages and involves more than one perpetrator:

  1. Victimization during childhood and victimization during adolescence or adulthood
  2. Victimization during adolescence and victimization during adulthood
  3. Victimizations during childhood, adolescence or adulthood
CLARIFYING TERMINOLOGY
Revictimization: The experience of victimization at two different life
stages or during the same life stage, by more than one
perpetrator.
Repeated
victimization:
Multiple experiences of victimization by the same
perpetrator during one life stage or across life stages.
Poly-victimization: Experiencing more than one type of victimization during
one life stage (e.g. sexual, physical and emotional abuse
in childhood).

3 arrows - Childhood Sexual Abuse, Domestic Violence, Sexual Violence
Repeated victimization and poly-victimization are distinct from, but can be involved in, revictimization. For example, a girl may experience emotional and physical abuse (i.e. poly-victimization) throughout her childhood from a caregiver (i.e. repeated victimization) and later as a teen experience bullying by a peer (i.e. revictimization), and then as an adult experience intimate partner violence (i.e. revictimization) in the form of sexual and physical abuse (i.e. poly-victimization) multiple times (i.e. repeated victimization).

UNDERSTANDING VIOLENCE AND HEALTH FROM A LIFE COURSE PERSPECTIVE

According to the life course perspective:5

  • Individual lives are characterized by a series of pathways or trajectories that span from early or later life.
  • Examining experiences of violence at only one point in time ignores previous experiences.
  • Previous experiences impact current vulnerabilities to abuse or use of violence as well as current and long-term health outcomes.
  • The cumulative impact of violence on health is shaped by social, economic, environmental, and cultural factors (i.e. the social determinants of health) that work across multiple levels (e.g. individual, interpersonal, community, societal).

THE IMPACT OF VIOLENCE ON THE HEALTH OF WOMEN AND GIRLS

The health consequences of any experience of violence can be severe. When violence is experienced across the life course, its impacts can accumulate over time. Adaptations that help girls and women survive violence may compromise their later functioning and well-being in other contexts (e.g. dissociation). As a result, women and girls can become increasingly vulnerable to poor health outcomes. Many outcomes are shared with different forms of victimization, but some are particularly prevalent or intensified for women and girls who have been revictimized (e.g. post-traumatic stress disorder, depression, poor physical health, alcohol/substance use). While the consequences of victimization for health are often similar across life stages, some are specific to or begin to emerge at certain time points. For example, the consequences of child or adolescent victimization appear as chronic disease, disorders, or pain in adulthood. The use of violence, particularly in childhood and adolescence, is also associated with adverse health outcomes for girls, such as the development of mental health difficulties.

The health consequences of violence against women and girlsa

Physical Psychological/Emotional Behavioural Interpersonal
Poor self-reported physical
health and quality of life
High medication use
Arthritis
Breast cancer
Alzheimer’s disease
Injuries (e.g. cuts, bruises,
sprains, broken or fractured
bones)
Sleep disorders
Somatoform disorders
Chronic pelvic pain
Sexually transmitted infections
Cardiovascular disease
Increased rates of
hospitalization
Hypertension
Irritable bowel syndrome
Chronic pain
Reproductive and
gynecological health problems
Digestive problems
Seizures
Traumatic brain injury
Disability
Death
Posttraumatic stress disorder
Depression
Anxiety
Suicidality
Psychological distress
Dysthymia
Obsessive compulsive disorder
Personality disorders
Bipolar disorder
Dissociation
Affect regulation difficulties
Conduct disorder
Anger management problems
Poor self-rated mental wellness
Substance abuse
Self-harm
Eating disorders
Risk-taking behaviours
High-risk sexual behaviours
Difficulty forming or
maintaining relationships
Social impairment
Perpetration of abuse
Bullying
Vulnerable to later
revictimization
Frequent relationship conflict
aBolded outcomes are unique to adulthood. Italicized outcomes are unique to childhood and adolescence.
(M. Bair-Merritt et al., 2006; J. C. Campbell, 2002; Chen et al., 2010; Cook et al., 2011; Devries et al., 2013, 2014; Elliott, Alexander, Pierce,
Aspelmeier, & Richmond, 2009; Lagdon et al., 2014; Maniglio, 2009; Norman et al., 2012; Richmond, Elliott, Pierce, & Alexander, 2008; Trevillion
et al., 2012; Turner, Finkelhor, & Ormrod, 2006; Wood & Sommers, 2011)15

RISK FACTORS FOR THE REVICTIMIZATION OF WOMEN AND GIRLS

Individual risk factors Characteristics of
abuse
Interpersonal risk
factors
Community risk
factors
Societal risk factors

Multiple traumas

Childhood physical
abuse

Childhood sexual abuse

Running away

Involvement in
prostitution

Psychological difficulties

Adolescent sexual
victimization

Recency of abuse
High frequency
High severity
Long duration
Type of contact (abuse
involving intercourse
= greatest risk of
revictimization)
Relationship to
perpetrator (greatest
risk if family member)
Poor parental
attachment
Change in caregivers
Drug/alcohol problems
of family member
Family/parental conflict
Presence of physical
abuse or neglect
Mental health problems
in family
Poverty
School environment
(e.g. violence, bullying)
Neighborhood violence/
crime
Gender inequality
Structural violence (e.g.
institutionalized racism,
sexism, ageism)
Socio-cultural norms
that promote rigid,
narrow stereotypes
of masculinity and
femininity, and that
support the use of
violence against women.

RISK FACTORS FOR THE USE OF VIOLENCE BY WOMEN AND GIRLS

4 circles starting with Invidivual, encompassed by Interpersonal then Community then Society.  Each circle includes a few examples.

 

THEORETICAL FRAMEWORKS

Most theories of revictimization focus on how early victimization alters psychological and psychosocial adjustment, abilities to recognize risk, and expectations of adult relationships. These alterations may then increase vulnerability to later victimization. Vulnerability to victimization can also result from interpersonal, community, and societal factors.

Discussing vulnerability for revictimization must not be interpreted as suggesting in any way that girls and women are responsible for the abuse they experience. Rather, explanations of vulnerability help to inform safety planning, effective supports, and prevention.

Many theories linking victimization to later use of violence draw attention to these factors and how they interact. According to the feminist ecological model, for example, girls exposed to family violence, negative peer influences at school or neighbourhood gangs, and who have limited resources and face racial oppression as a result of social inequalities in society may have an increased likelihood of engaging in aggressive behaviour. Still, more work is needed on how pathways to violence may be unique for women and girls relative to men and boys.

While many multi-level factors contribute to the victimization of women and girls, it is important to remember that women and girls are targeted because of their sex. Institutional practices and social norms have historically maintained unequal power relations between men and women, which can perpetuate or promote violence against women and girls. In other words, because of their unequal position in society, women and girls face increased vulnerability to violence.

Revictimization Theories Theories Linking Victimization to Later Use of
Violence
Sociodevelopmental approach
Revictimization theoretical model
Emotional avoidance theory
Steel & Herlitz model
Traumagenic model
Learning theory
Learned helplessness
Ecological approach to revictimization
Lifetime victimization and aggression model
Social learning theory
Neurobiological explanations
Feminist ecological model
Typology of female perpetrators of intimate partner
violence
Trauma theory
Attachment theory
Social information processing model
*For a detailed summary of each theory, please click here and see Table 6 (p. 14), Table 7 (p. 15) and Table 8 (p.17).

REVIEWING THE EVIDENCE: REVICTIMIZATION

The evidence presented here is not intended to suggest that all women who experience violence early in their lives will have subsequent experiences of victimization as they age. It should be interpreted within the larger social context affecting women and girls’ vulnerability to violence (e.g. gender-based inequalities, structural violence). While many factors may increase vulnerability to victimization and revictimization, those who victimize others remain responsible for their actions.

The evidence consistently indicates that women who experience any form of childhood violence are more likely to be victimized again in childhood, adolescence, and/or adulthood.

Both cross-sectional and longitudinal studies find links between childhood maltreatment and:

  • maltreatment later in childhood
  • sexual assault in adolescence/adulthood
  • physical assault in adolescence/adulthood
  • dating or intimate partner violence in adolescence/adulthood
  • peer victimization (e.g. bullying) in childhood and adolescence
  • abuse or aggression from siblings in childhood and adolescence

Adolescence and young adulthood appear to be key life stages for revictimization to occur. For example, significant relationships have been found between victimization in childhood or adolescence and victimization during the first or second year of post-secondary study.9 Bullying victimization prior to age 15 also increases the risk of experiencing physical partner violence, sexual violence, aggression from peers, and/or criminal violence by age 21.10

RESEARCH HIGHLIGHTS

Girls who experience sexual abuse in childhood are 7 times more likely to be revictimized one year later and 2 to 3 times more likely to be revictimized in adolescence and/or adulthood compared to girls who have not been abused.6 Women victimized as children are 6 times more likely to be revictimized in adulthood compared to women never victimized as children.7

30% of female first-year students report some form of sexual violence prior to starting university; 41% of these women experience sexual revictimization while in university.8

Key Definitions

Child maltreatment: includes all forms of physical abuse, sexual abuse, and psychological abuse directed toward a child as well as neglect of a child and exposure to intimate partner violence.

Sexual violence: any sexual act committed against a person without their freely given consent. This includes physical and verbal coercion as well as noncontact acts of a sexual nature. Sexual violence can occur in partner and non-partner relationships.

Intimate partner violence (IPV): refers to a range of abuse behaviours perpetrated by a current/former partner, including but not limited to physical, sexual, and psychological or emotional harm.

Dating violence: a type of IPV often referred to in the context of adolescence relationships. It occurs between two people in a dating relationship and involves physical, psychological, and sexual abuse.

Sibling violence: physical, emotional and/or sexual violence committed against one sibling by another.

Peer violence: aggression or violence that occurs between peers (i.e. individuals who are not related or romantically involved).

REVIEWING THE EVIDENCE: LINKING MALTREATMENT AND LATER USE OF VIOLENCE

While more female-specific studies are needed to further examine this relationship and understand gender-specific pathways, the evidence suggests women’s use of violence is intricately linked to their victimization experiences.

Cross-sectional and longitudinal research finds a strong association between childhood maltreatment, sibling violence, or bullying victimization and the future use of violence by women and girls. Girls and women most commonly use violence against dating or intimate partners, children, or peers. There is, however, limited available evidence linking childhood maltreatment to the use of violence in adulthood against parents once they have aged.

Late childhood and adolescence are significant life stages where maltreated girls may begin to use violence. Overall, rates of violent offending among female youth under 18 years of age generally exceed those of adult women.11

Childhood maltreatment is associated with the perpetration of the following forms of violence during these periods:12

  • aggressive behaviour toward peers
  • physical assault
  • cyberbullying
  • bullying
  • fighting
  • sexual harassment
  • sexual assault
  • physical dating violence
  • child maltreatment (by young mothers against their own children)

VIEWING VIOLENCE USED BY WOMEN AND GIRLS IN CONTEXT

Female-perpetrated violence is an important public health issue and often a consequence of experiences of victimization. Not all women and girls who experience victimization will later use violence. Among those who do, it is important to cautiously interpret existing statistics.

For example, higher rates of some forms of child maltreatment perpetrated by women may be a result of women spending more time with their child(ren) as the primary caregiver in accordance with societal gender roles and norms. However, child sexual abuse and child physical abuse resulting in severe injuries or fatalities are more often perpetrated by men.13

While women use violence against intimate partners, they may do so to protect themselves or their children. Even when violence is perpetrated against a partner who is not abusing them, violence is less likely to result in serious physical harm or homicide. The fact remains that most serious IPV and sexual violence is committed against women by men and men more often perpetrate violence involving significant physical threats, serious injury, or death of a female partner.14

Ultimately, when men use violence against women and girls, it is typically an exercise of power, while women’s use violence is often a response to their powerlessness. In either case, gender inequality remains a root cause.

CONSIDERATIONS AND FUTURE DIRECTIONS

Key issues facing research on the links between the victimization of women and girls and their subsequent revictimization or use of violence:

  1. Need to incorporate an intersectional approach:
    Include diverse groups of women and girls and contextualize experiences within larger systems of oppression, which create inequalities, reinforce exclusion, and increase vulnerabilities to violence.
  2. Examine links along the continuum of violence:
    Determine the relationship between childhood maltreatment and later experiences of sexual harassment, reproductive control, financial abuse, and other forms of violence outside of the more commonly studied experiences of sexual or physical abuse/assault.
  3. Increase number of Canadian longitudinal studies.
  4. Need for consistency in definitions of abuse, time periods studied, and methodology.
  5. Greater attention to female-specific pathways to violence is needed.

Implications for prevention:

  1. Late childhood, adolescence and young adulthood are critical life stages for prevention efforts.
  2. A trauma-informed approach that takes into account lifetime victimization is needed in services for women who have experienced and/or used violence.

WRITTEN BY:

Nicole Etherington, Ph.D., Research Consultant, Centre for Research & Education on Violence Against Women & Children, Western University

Linda Baker, Ph.D., C.Psych., Learning Director, Centre for Research & Education on Violence Against Women & Children, Western University

GRAPHIC DESIGN:

Elsa Barreto, Multi-media Specialist, Centre for Research & Education on Violence Against Women & Children, Western University

ISBN:

978-1-988412-06-1

FOOTNOTES

  1. Sinha, M. (2013). Measuring violence against women: Statistical trends. Juristat (Statistics Canada). Ottawa, ON.
  2. Afifi, T. O., MacMillan, H. L., Boyle, M., Taillieu, T., Cheung, K., & Sareen, J. (2014). Child abuse and mental disorders in Canada. CMAJ : Canadian Medical Association Journal, 186(9), E324-32.
    Burczykcka, M., & Conroy, S. (2017). Family violence in Canada: A statistical profile, 2013. Juristat. Ottawa, ON.
    Public Health Agency of Canada. (2006). Child Maltreatment in Canada. Ottawa, ON. Retrieved from http://www.phac-aspc.gc.ca/sfv-avf/sources/nfnts/nfnts-2006-maltr/index-...
  3. Classen, C. C., Palesh, O. G., & Aggarwal, R. (2005). A Review of the Empirical Literature. Trauma, Violence, & Abuse, 6(2), 103–129.
  4. Kimerling, R., Alvarez, J., Pavao, J., Kaminski, A., & Baumrind, N. (2007). Epidemiology and consequences of women’s revictimization. Women’s Health Issues, 17, 101–106.
  5. Greenfield, E. A. (2010). Maturitas Child abuse as a life-course social determinant of adult health. Maturitas, 66(1), 51–55.
    Davies, L., Ford-Gilboe, M., Willson,  a., Varcoe, C., Wuest, J., Campbell, J., & Scott-Storey, K. (2015). Patterns of Cumulative Abuse Among Female Survivors of Intimate Partner Violence: Links to Women’s Health and Socioeconomic Status. Violence Against Women, 21(1), 30–48.
  6. Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007). Re-victimization patterns in a national longitudinal sample of children and youth. Child Abuse and Neglect, 31(5), 479–502.
  7. Kimerling et al., 2007.
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